Cleft Lip and Palate

The fourth most common birth defect in the United States, cleft lip and cleft palate affect one in every 700 newborns each year. A cleft lip is a separation of the two sides of the lip, usually involving the bones of the upper jaw, upper gum, or both. A cleft palate is an opening in the roof of the mouth in which the two sides of the palate did not fuse or join together properly. Cleft lip and cleft palate can occur on one side or both sides.

Because cleft lip and cleft palate are apparent at birth, most people have surgery to correct the defect early in life. However, follow-up surgery often is necessary later on to treat any deformities that still exist after initial treatment. These may include deformities of the lip and nose, as well as abnormalities of the teeth and jaw. Oral and maxillofacial surgeons specialize in the evaluation and treatment of various problems of the teeth and jaw resulting from cleft lips and palates.

Unrepaired oronasal fistulae, which is a hole between the mouth and nose cavity

Alveolar clefts, which are defects in the bone that supports the teeth

Before any treatment is planned, you will meet with an oral and maxillofacial surgeon for a complete medical evaluation. During this visit, your surgeon will start by asking about your medical history and conducting a thorough physical and dental examination, noting any problems you are experiencing due to your cleft lip or palate.

After this evaluation, your surgeon will discuss the treatment options that best meet your individual needs.

Bone Grafting

Although bone grafting is most frequently performed on children under the age of 10, adults also can benefit from the procedure. Bone grafting in the dental ridge of the upper jaw, called the maxilla, is now the standard treatment for patients with facial clefts. The procedure involves taking a small amount of bone from one place — usually the hip, head, ribs or leg — and placing it in the area of the cleft near the teeth.

Bone grafting is performed to:

Provide support for the lip and nose and to improve symmetry

Form a continuous upper gum ridge, creating a more natural appearance and adding stability to the ridge

Improve the stability of the front part of the roof of the mouth, if a cleft on both sides is present